With details on price transparency left to regulators, the options range from crystal clear to smaller reforms.
Eliminating surprise medical bills, improving transparency in prices, as well as revealing how prices are negotiated were the focus, but details about how information must be provided was left to the regulations, in an Executive Order signed by President Trump on June 24, 2019.
Policy statement. The Executive Order states that the federal government aims to:
- eliminate unnecessary barriers to price and quality transparency;
- increase the availability of meaningful price and quality information for patients;
- enhance patients’ control over their own healthcare resources, including through tax-preferred medical accounts; and
- protect patients from surprise medical bills.
Hospital regulation coming. Under the Executive Order, the Secretary of Health and Human Services (HHS) must propose a regulation to require hospitals to publicly post standard charge information. The information must include charges based on negotiated rates and information on common or shoppable items and services. The text must be in an easy-to-understand, consumer-friendly, and machine-readable format that informs a patient’s decision-making process, and allows patients to compare prices across hospitals. In addition, the regulation should require hospitals to post standard charge information for services, supplies or fees. The regulation must be proposed within 60 days of the Executive Order.
Report on impediments. The Secretary of HHS must issue a report describing how the federal government and/or the private sector are impeding healthcare price and quality transparency for patients. The report must also give recommendations for eliminating the impediments found, in a way that promotes competition. Specifically, the report should describe why lower-cost providers generally avoid healthcare advertising.
Guidance on high-deductible plans. The Secretary of the Treasury must issue guidance to expand the ability of patients to select high-deductible health plans. The plans must be able to be used with a health savings account and must cover low-cost preventive care (before the deductible) for medical care that helps individuals with chronic conditions. Regulations to treat expenses related to certain types of arrangements, potentially including direct primary care arrangements and healthcare sharing ministries, must also be proposed.
Surprise medical bills. The Secretary of HHS is also required to submit a report to President Trump on more steps that can be taken by his administration to implement the principles on surprise medical billing announced on May 9, 2019.
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